Last Monday, President Donald Trump released his 2019 budget proposal, “An American Budget,” providing guidance to Congress on how to spend hundreds of billions of dollars in new federal spending plan authorized by the Bipartisan Budget Act recently passed into law. Trump’s federal spending wish list clearly shows that many programs and services for older Americans will take a huge hit if any of these proposals are picked up by the Republican-controlled Congress.

The Washington, DC-based National Committee to Preserve Social Security and Medicare (NCPSSM) expresses concern that Trump’s budget proposal contains many of the same harmful proposals that the Administration and Republican-controlled Congress has pushed before, including $1.4 trillion in Medicaid cuts, $490 billion in Medicare cuts, and repeal of the Affordable Care Act.

Social Security on the Chopping Block

According to the NCPSSM’s analysis released this month, the President’s budget blueprint calls for deep cuts to Social Security Disability Insurance, breaking his campaign promise not to touch Social Security.

Trump proposes to slash up to $64 billion from Social Security Disability Insurance (SSDI) benefits through eight demonstrations “ostensibly” geared toward helping disability beneficiaries to stay at work or return to work, says NCPSSM, noting that these Social Security Administration’s (SSA) demonstration projects, established in 1980, had only “a modest effect on beneficiaries’ workforce participation.”

NCPSSM’s analysis warns that the President’s proposed budget also calls for other benefit cuts for disabled seniors, including limiting the retroactivity of applications for disability benefits from 12 months to six months. It would also deny unemployment compensation payments to SSDI beneficiaries who work but get laid off. Social Security Income recipients that live together, even with families, would see their benefits reduced, too.

The Trump Administration also proposes $12.393 billion for SSA’s FY 2019 appropriation for administrative funding, says NCPSSM, warning that this $89 million funding cut will result in longer waits for decisions on initial disability claims and time to speak to a representative from SSA’s 800 number. “With 10,000 baby boomers reaching age 65 every day, SSA needs substantial yearly increases just to keep pace with increased workloads, says NCPSSM.

President Trump’s budget plan only funds production and mailing of only 15 million Social Security statements. “This proposal is part of SSA’s overall plan to limit sending statements only to individuals who are 60 or older rather than sending them to all workers every five years,” says the aging advocacy group, urging the Administration “to send these important financial planning documents to all workers, as is required in section 1143 of the Social Security Act.”

Medicare Takes a Blow

President Trump’s draconian budget calls for over $500 billion in cuts to Medicare, many of these savings coming from cuts to Medicare providers and suppliers. This is another campaign promise broken.

NCCPSSM warns that President Trump’s 2019 budget proposal also includes policy changes to the prescription drug benefit that would impact Medicare’s spending and beneficiary costs. It would create an out-of-pocket maximum for Part D. Medicare t beneficiaries with very high drug costs would no longer have cost sharing responsibility once they hit the catastrophic threshold. This would add $7.4 billion in costs over 10 years.

Trump’s budget proposal would also change the way the threshold for moving out of the coverage gap or “donut hole”” is calculated that would make it more costly to seniors to move through it. “Taken together with an out-of-pocket cap, it will mean savings for some seniors with very high drug costs, but costs will climb for a larger number of seniors. This saves $47.0 billion over 10 years,” reports NCPSSM.

Finally, Trump’s 2019 budget proposal saves $210 million over 10 years by eliminating the cost-sharing on generic drugs for low-income beneficiaries.

Hurting Medicaid Recipients

In FY 2015, federal and state governments spent about $158 billion or 30 percent of Medicaid spending on long-term services and supports (LTSS). The federal and state partnership pays for about half of all LTSS for older adults and people with disabilities.

Even with promising to save Medicaid, the President’s 2019 budget proposal slashes the program’s funding by changing the structure of the program into either a per capita cap or Medicaid block grant, with a goal of giving states more flexibility of managing their programs. Through 2028, the president’s budget would cut $1.4 trillion from the Medicaid program through repealing the Affordable Care Act, restructuring the program.

NCPSSM expresses concern that if states lose money under per capita caps or block grants, state lawmakers would have to make up the funding themselves if federal funds do not keep up with their Medicaid population’s needs. This can happen by either by cutting benefits and/or limiting eligibility, requiring family members to pick up more nursing home costs, or scaling back nursing home regulations that ensure quality, service and safety protections.

And That’s Not All

NCPSSM’s analysis says that Trump’s budget proposal also calls for the elimination of the Older Americans Act Title V Senior Community Service Employment Program (SCSEP). The program, funded $ 400 million in FY 2017. provides job training to nearly 70,000 low-income older adults each year.

Community Services Block Grants ($715 million), the Community Development Block Grant ($3 billion) and the Social Services Block Grant ($1.7 billion) programs are also targeted to be eliminated. Some Meals on Wheels programs rely on funding from these federal programs, in addition to OAA funding, to deliver nutritious meals to at-risk seniors.

Trump’s 2019 Budget proposal would also eliminate funding for the Low-Income Home Energy Assistance Program (LIHEAP) This program received $3.39 billion in FY 2017. “Of the 6.8 million households that receive assistance with heating and cooling costs through LIHEAP each year, 2.26 million or one-third are age 60 or older,” says NCPSSM.

Trump’s budget plan also eliminates funding for Senior Corps programs including the Retired and Senior Volunteer Program, Foster Grandparents and Senior Companions. Current Senior Corps funding at the FY 2017 level is $202.1 million. “These programs enable seniors to remain active and engaged in their communities, serving neighbors across the lifespan, and benefitting their own health in the process. In 2016, 245,000 Senior Corps volunteers provided 74.6 million hours of service,” says NCPSSM.

Finally, research into cancer, Alzheimer’s Parkinson’s and other diseases affecting older persons will be negatively impacted with $ 46 million in funding cuts to National Institute on Aging at the National Institutes of Health.

Aging advocacy groups view Trump’s second budget “flawed,” jam-packed with “damaging policies” for Congress to enact with an aging population. It’s “Dead on Arrival.” If Trump and GOP lawmakers choose not to listen to their older constituents, the results of the upcoming mid-term elections might just get their attention.

Herb Weiss is a writer covering aging, healthcare and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.